The prostate is a gland of the male reproductive system, located directly under your bladder. This gland consist of tiny other glands that produce a fluid which is a part of the semen. Prostate cancer begins when the cells present in the prostate gland start to grow uncontrollably. The cancer starts with tiny changes in the shape and size of the prostate gland cells- known as Prostatic intraepithelial neoplasia (PIN).

Prostate cancer is a very slow progressing disease. In most cases, patients do not realise that they are suffering from this condition. When the cancerous tissues start spreading or there is a serious life risk, one may need to undergo a prostate cancer surgery. There are various types of surgery that can be performed for treatment such as radical retropubic prostatectomy, radical perineal prostatectomy or modern laparoscopic techniques.

The 4 stages of prostate cancer are:

• Stage 1: In this stage, cancers are small and grow gradually. Though they are within the prostate, not be able to detect during a physical examination. This stage may not bring out any symptoms or other health issues.
• Stage 2: In this stage, the cancers in the prostate can be felt by the doctor as they are larger than the stage one cancer. The two types of cancers in stage 2 are 2a and 2b. 2a cancers can be T1 tumors with high PSA or T2 or T2b with lower PSA. 2b cancers can be T2c tumors or T2a or T2b with higher PSA.
• Stage 3: Now at this stage, the cancers have grown outside the prostate very fast. They may have reached the seminal vesicles that not the rectum or bladder. This stage of cancer is mostly returnable after the treatment.
• Stage 4: This is a metastasize stage. It is likely to spread to nearby organs such as rectum, bladder or nearby lymph nodes. Distant organs such as bones may also be affected. Mostly, this stage is not curable.

This serious ailment affects middle-aged or older people and especially over 65 years old men are more prone to prostate cancer. Men in the early stage do not have any symptoms. The possible changes occur as follows :

1. Difficulty in urinating or emptying the entire urinary bladder
2. Dribbling urine even after complete urination
3. Sudden urgency to urinate

When the cancer advances (metastasize), the symptoms are:

1. Bloody urine or semen
2. Severer back or pelvic pain
3. Unintentional weight loss
4. Problems in erection
5. Numbness in the feet, hip or leg.

A patient may require a prostate cancer surgery in the following conditions:

• The age, general health and stage of cancer determine whether a patient would need surgery or not
• For removing the cancerous tissues
• Treating localized prostate cancer, which involves removing the entire prostate and the surrounding tissues, including lymph nodes if necessary
• If the cancer has reached the outer layer of the prostate and is spreading in the seminal vesicles
• When the cancer is spreading to the other parts of the body. It could be to the nearby lymph nodes, and other organs like rectum, bladder or the pelvis.

While treating the early stage of prostate cancer, the problems faced by the patients will be more than the disease itself. It is always recommended for active surveillance or watchful waiting. During active surveillance, the cancer is monitored very closely for any sign worsening. When cancer found to be worsening, the treatment will be immediately started.

In surgery, the prostate gland and the surrounding tissues and lymph nodes are removed. This is called Radical prostatectomy. It is done in two ways such as robotic and incision.

High-power energy is given through radiation to kill the cancer cells. In prostate cancer, it is given in two forms such as external beam radiation and brachytherapy.

In hormone therapy, medicines will be given to stop the body from producing testosterone. The growth of cancer cells die or come down gradually when cutting down the production of testosterone.

Pre Procedure:

Before surgery, you may have to undergo a cystoscopy so that the doctor can examine your prostate size and urinary system. Other tests for measuring your prostate and urine flow will also need to be conducted. Apart from this, there are certain instructions that need to be followed:

    Inform your doctor of all the medications that you are take and see if you need to stop taking any of them before the surgery. For example, you may be advised to stop medicines that can increase the risk of bleeding during the surgery.
    You may have to stop drinking and eating anything from the midnight on the day of your surgery. In case you need to take any medication, make sure you have it with very little sips of water.
    An enema may be required to be done prior to the surgery. Enema is a procedure for cleansing the bowel before a medical examination or surgery.

During Procedure:

A prostate cancer surgery can be done in two ways. The main type is known as radical prostatectomy. There are further two ways to perform this operation. One is radical retropubic prostatectomy, where the surgeon makes a cut in the lower abdomen. You will be administered general or epidural anaesthesia. The prostate gland and the nearby tissues will then be removed. In case there is a possibility that the cancer has spread to the lymph nodes nearby, the surgeon may remove them too during the surgery.

The second type is the radical perineal prostatectomy, where the incision is made in the skin between your anus and scrotum. The lymph nodes cannot be removed in this case. This surgery requires less time, causes less pain and has a faster recovery period. However, there are possibilities of erection problems in patients undergoing this surgery.

There are laparoscopic approaches too for conducting a prostate cancer surgery where much smaller incisions and long surgical tools are used for removing the prostate.
Post Procedure:

After the surgery has been performed, a catheter is placed in the penis so that the bladder can be drained. You need to keep the catheter for 1-2 weeks. Depending on your condition, the doctors will decide if you can be discharged in a day or if you need to spend a few more days in the hospital. You will be instructed on handling the catheter and caring for the surgical site before you go home.

The incision site can be sore for a few days. There may be other problems like blood in the urine, urinary irritation, difficulty in holding urine, urinary tract infection (UTI) and inflammation of the prostate. These symptoms are normal and will be there for a few weeks post-surgery. It is advised to decrease your activity levels for the time being, including sex.

Prostate cancer surgery success rate:

When it comes to the treatment, prostate cancer surgery success rate varies. According to a reference paper, patients with their chosen treatment (i.e., surgery, radiation or watchful waiting/active surveillance)

Patients expected to live:

• Fewer than five years - 3 percent
• Five to 10 years - 9 percent
• 10 to 20 years - 33 percent
• More than 20 years - 55 percent.

1. Incontinence: Both the prostate tumor and its treatment can lead to urinary incontinence. Patients with urinary incontinence start to lose bladder control and may leak urine or not be able to control during urination.

2. Erectile dysfunction: The nerves that are responsible for erection are located close to the prostate gland. A tumor or treatments such as radiation or surgery can damage such weak nerves. At last, this may ultimately lead to achieving or maintaining an erection.

3. Metastasis: This type of cancer spreads mostly to all parts of the body and leads to complications such as weakness in legs and arms, spinal cord compression that ultimately leads to urinary incontinence, muscle weakness, stiffness in the neck, thigh, broken bones and severe pain in the spinal cord.

There is a small risk of developing second cancer near or in the radiation field which is called secondary cancer. Since the healthy tissues are targeted to the radiation, secondary cancer can develop. Though modern radiation limits exposure, it is not always possible to protect all the healthy cells.

After the radiation treatment, most of the men turn sterile. It is always advisable to store sperms in sperm banking for the future child. In Internal radiotherapy, proctitis is being a long-term effect. This condition creates a feeling of straining whether you actually need to pass poop or not. Mucous discharge and bleeding may also occur from the rectum.

As a surgery for prostate cancer is a major surgery, it is important that you give your body some time to recover. Take adequate rest while recuperating at home, and refrain from lifting any heavy objects for a few weeks. It is also recommended to avoid driving in the first few days. It can take about 6-7 weeks to feel normal again. Make sure that you take your medicines in time and follow the instructions of your doctor, including any lifestyle changes that you need to make.

Foods to avoid after prostate cancer are:

• Fat: Decent amount of fat needs by the body to work properly. And yet, eating a lot of will put the weight that expands the danger of forceful or propelled prostate disease. Having vegetable oils instead of animal fats seems to increase the longevity of men with prostate cancer.
• Calcium and dairy nourishments: It has been accounted for that eating a great deal of calcium may expand the threat of prostate malignant growth is developing and spreading. It is advised to consume 2000 mg of calcium per day that is enough to keep your bone healthily.
• Alcohol: Regular and large amounts of alcohol intake increases prostate cancer’s risk. Instead of alcohol, men may consume sparkling juices, non-alcoholic wines or beers, fresh fruit juice, and tea.
• Trans fatty acids: These are known to advance cancer growth. Margarine, fried and baked foods are rich in trans fatty acids.

Prostate cancer exercises:

• Prior to surgery, you can do Kegel works out. Rests or sit in a seat dependent on your solace level, contact your pelvis on the floor for in any event 10-seconds and pursued by a 10-second rest. Repeat the same for five minutes. Play out this activity at any rate three times each day until you go for surgery.
• After surgery with the advice of your doctor start with a subtle contraction when you are lying down. Hold the contraction posture for 3 seconds, relax for 15 seconds. Continue it for five repetitions three times a day. Perform the same by sitting or standing in the next step. Start with a five-second hold and relax 15 seconds.

• Green tea holds Catechins (antioxidants) that are abundant in the product. It shows an improved immune system and potentially slows down the progression of prostate cancer.
• Lycopene is a pigment that can naturally be found in fruits and vegetables. It has been reported that Lycopene helps in slowing the progression of benign prostate cancer. Eating Lycopene-rich tomatoes is advised to decrease growth.
• Omega-3 Fatty Acids have the tendency of fighting against inflammation and thus fight against prostate cancer. Salmon and Mackerel fish contain more omega 3 fatty acids.
• Stinging nettle contains antioxidants and anti-inflammatory compounds and these are essential to battle against prostate cancer.